Asthma diagnosis is a complex matter | Letters

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The watchdog has drafted new guidance, its first for asthma, for doctors in England to improve the accuracy of diagnoses, including an array of tests.

Prof Mark Baker, director of clinical practice at Nice, said: “Asthma is a long-term incurable condition that affects millions of people of all ages. If left untreated, asthma attacks can be life-threatening.

“However, with appropriate treatment and thoughtful monitoring, most people will be able to successfully control their symptoms and be spared from serious harm.

“Accurate diagnosis of asthma has been a significant problem, which means that people may be wrongly diagnosed or cases might be missed in others. Our aim with this guideline is to give clarity and set out the most clinical and cost-effective ways to diagnose and monitor asthma based on the best available evidence.

“This new draft guideline provides advice for primary, secondary and community care healthcare professionals on the most suitable tests for accurately diagnosing asthma and how to help people monitor and control their symptoms. We now want to hear from all those who provide care for people with asthma in the NHS to ensure all relevant views are considered for the final guideline.”

Asthma is one of the world’s most common chronic diseases in childhood, affecting 1.1 million children and 4.3m million adults in the UK.

About 10% of the 5.4 million people in the UK with asthma have the most severe form, which leaves them unable to control their symptoms, resulting in frequent attacks, despite taking multiple high-strength medicines.

Nice also said while there was no “gold standard test” available, with patients diagnosed based on a medical history, it recommended spirometry – a measure of airflow obstruction – as the primary method for children over five and adults over 16.

For children under five, doctors should monitor nitric oxide levels until they are old enough for clinical tests.